The details of the scandal sweeping the New York Republican Party are tawdry, sad and infuriating — and a wake-up call to a national party that is urgently seeking to make inroads among black, Latino, and young voters.

Barely two weeks after RNC Chairman Reince Priebus and New York state Republican Chairman Ed Cox held a press conference at a black church in Brooklyn to launch the party’s ambitious, $10 million diversity campaign, FBI agents arrested Malcolm Smith, a longtime black state legislator.

According to federal prosecutors, Smith spent months organizing cash bribes to two top city Republican officials in exchange for a slot on the ballot in this fall’s Republican primary for mayor. Unfortunately for Smith, a real estate tycoon he enlisted to make cash payments was, in fact, an undercover FBI agent, according to federal prosecutors

Without getting into the FBI’s habit of targeting prominent Blacks, and the question of whether anything would have happened had their guy not offered money, the question of how smart this fellow was has to be answered.

A good rule is, never do anything in secret that you don’t want to see top-of-the-hour on CNN.

I’ve been thinking of offering a service: If anyone has any questions about what to do in some case, they can call me on the phone. I’ll advise ’em. Imagine how differently things might have gone:

Bill Clinton: Hey, Jim, there’s a young lady named Monica here offering a blowjob. Should I accept it?

Me: No, Bill. Bad idea. Go see a movie instead.

Eliot Spitzer: Jim, this nice young lady is asking for four thousand dollars for a night of pleasure. Should I?

Me: Eliot, bad idea. Go see a movie instead.

Erik Menendez: Hi, Jim. Me and my brother want to shoot our parents, say it was a robbery gone wrong, and live on their money. Should we?

Me: Dude. Do you want to do life without parole? Go see a movie instead.

Bill Allen: Jim, I’ve been thinking of fixing my friend Ted’s house for free if he’ll vote for a law that gives special privileges to my oil company. Do you think I should?

Me: No, Bill. Bad idea. For both of you. What’s playing down at the Roxie?

Died, amid the smell of roses, in 1582, canonized in 1622, named a Doctor of the Church in 1970, St. Teresa is patron saint of bodily ills, headaches, chess, lace-makers, the loss of parents, people in need of Grace, people in religious orders, people ridiculed for their piety, the city of Pozega in Croatia, sick people, sickness in general, and Spain. Her feast day is October 15.

Considered (along with St. John of the Cross) founder of the Discalced Carmelite Nuns of the Primitive Rule of St. Joseph. On the day St. John of the Cross knocked at her door, St. Teresa (who was exceedingly tall, and known to her friends as “Long Teresa”) remarked to St. John of the Cross (who was exceedingly short), “God be praised! He has sent me half a monk!” St. Teresa also remarked to God, in her prayers one day, “If this is the way You treat Your friends it’s no wonder You have so few.”

St. Teresa’s books, The Interior Castle, The Way of Perfection, and autobiography Life Written by Herself, are still in print. Her collected letters are also available.

St. Teresa is famous for her religious ecstasies, during which she was embarrassed to levitate. She was also an avid gardener.

In her youth she delighted in reading romance novels, which she shared with her mother, but kept secret from her father on the grounds that he would not approve of such frivolity.

Step 1: Tell your sister/coworker/rabbi, “Hey, tomorrow is Pi Day! We should celebrate with fresh pie. Too bad I don’t live near a bakery. I suppose I could just get some from the grocery store.”

Step 2: Watch as a look of horror crosses their face. Repeat your offer to go to the grocery store for pie. “I’m sure they made it sometime this week. It’ll be fresh enough.”

Step 3: When they offer to bake a pie from scratch that night, say, “Oh, you shouldn’t go to all that trouble. I’ll just go to the grocery store at lunch tomorrow and bring some pie to the office.”

Step 4: The next morning, at your sister’s house/place of employment/synagogue, enjoy some nice Free Pie with your coffee.

Jennifer Pelland is the author of the novel Machine as well as several dozen published short stories. Because spare time is for the weak, she’s also a performing belly dancer and occasional radio theater actress.

I am now mostly back on the job at Tor. Except not tomorrow. Spare a thought for TNH, who goes in at 10 AM EST for surgery to reconstruct her several-ways-abused left foot. I’ll be with her, or nearby, throughout.

It’s not actually a gigantic medical deal in the greater scheme of things, but FOOT. KNIVES. BONE. Ay yi! Wish us well.

I’ve been sick for nearly three weeks now—first with the evil norovirus, then with a viral lung-and-sinus thing which went bacterial. Teresa has had much the same stuff, in slightly different order. We wound up canceling on Boskone, much to our regret.

I was in the office for some partial days last week, but basically I’m completely behind on everything. If it seems to you that I’m taking even longer than usual to answer your email, return your call, issue your contract, read your story, think about your proposal, write your convention bio, generate your catalog copy, or whatever else it is you’re waiting on me to do, you’re not wrong. It’ll all get done eventually, but service is definitely delayed due to circumstances beyond our control.

I am now taking a course of antibiotics, and reflecting, not for the first time, on the fact that “antibiotic” basically means “poison we take on purpose while hoping it kills only the bad stuff.” Microbial civilizations are dying inside of me. I have no brain.

It’s a thought that arose when I was reading a review and came across this passage:

At one point during my time with Glass, we all went out to navigate to a nearby Starbucks — the camera crew I’d brought with me came along. As soon as we got inside however, the employees at Starbucks asked us to stop filming. Sure, no problem. But I kept the Glass’ video recorder going, all the way through my order and getting my coffee. Yes, you can see a light in the prism when the device is recording, but I got the impression that most people had no idea what they were looking at. The cashier seemed to be on the verge of asking me what I was wearing on my face, but the question never came. He certainly never asked me to stop filming.

My first reaction was…not good. They were told to stop filming, and they didn’t? Pretty damn intrusive. But I wondered if I was overreacting, so I let it slide. Then I saw (and Parheliated) this much-linked article. It expresses a slightly different problem, equally valid but rather more generally interesting (and a little less fraught). That one’s no longer “a feature that no one’s talking about”.

It made me revisit my earlier discomfort. The resultant tweet’s been much retweeted, and I’ve had some interesting conversations as a result. A few thoughts arising from them:

It looks like it would be harder to enforce a ban on creepshots than on copyrighted material.

This is partly because we already have the technological infrastructure in place around copy protection: watermarks, automated comparison algorithms, all that gubbins.

The technological infrastructure is in place because it’s been worth people’s money to overcome technical obstacles and set up systems. Smart people have been well-paid to do so.

We also have the cultural and legal infrastructure in place. We’ve made the choice (not me, and not without protest, but we as a society have done) that fair use is acceptable collateral damage in the protection of copyrighted material. Hollywood has lobbyists and legislation.

There’s no money in limiting creepshots.

No money means no history of effort put into dealing with the obstacles, either technical or social.

No history of effort put into overcoming them means the obstacles look insurmountable.

Various solutions floated around my Twitter stream, some serious, some not: facial recognition tied to a Do Not Photograph database; a lapel pin broadcasting a signal that disables the camera; dazzle camo. Giving up and licensing images for a fee. Pretty good notions for a bunch of amateurs spitballing in their spare time. But, as @awa64 pointed out during a really interesting exchange:

@evilrooster @trinandtonic I’m uncomfortable with the idea of privacy as an opt-in, as it seems to lead to victim-blaming.

That’s one of the serious social (rather than technical) problems to limiting the Google Glass’ ability to photograph people in public. There are others. For instance, any solution—technical or legal—that a woman on the subway can use, a misbehaving police officer can use as well. Is that a more or less acceptable sacrifice to make than fair use? I honestly don’t know. I think there’s a hard discussion to be had there.

But I have the weary suspicion that what we will end up doing is nothing, because that’s the way our technological innovations generally work: implement first, dismiss the consequences later. Still, somewhere in this wide-ranging discussion, I caught a glimpse of a world where the safety and respect of real human beings got the same kind of innovative, problem-solving attention that Steamboat Willie does. It was just a glimpse of a possibility, but it intrigued me.

We cannot make sense of it. Why does American history apparently begin with a giant meteor striking the Appalachians? What’s up with Daniel Boone et les Shawnee? And for ghod’s sake, why is there an interview with Donald Trump?

Like many of us on Making Light, I am much intrigued by myths and how we retell them as times change. One I’ve been tracking for some time is the myth of the Finding of the True King (or Queen). We don’t go in much for swords in stones any more, and scrofula turns out to be treatable by antibiotics—at least until the drug-resistant strains take over. But we’re still telling the stories.

I caught a whiff of the myth while I was watching Tangled. There’s a scene where Flynn the thief, trying to scare Rapunzel, takes her to the wretchedest hive of scum and villainy he knows: the Snuggly Duckling tavern, where all the brigands and murderers hang out. It doesn’t work out quite how he expects. By the time she’s done with them, these scary men have told her all of their secret dreams and hopes. She gives them the encouragement to be their true selves, their best selves, whether that’s a stage pianist or a mime. Having been transformed, they then rescue her later on in the film. She’s their queen long before even she knows it.>

But Tangled was about other things for me, so I filed the observation and moved on.

The thought resurfaced this past Christmas when I watched a Dutch film, Koning van Katoren (King of Katoren). It’s about a young man named Stach who decides to apply for the vacant position of king of his (modern) European country. The ruling junta set him a bunch of Herculean tasks—curing diseases, fighting dragons, defeating wizards*—and settle back to wait for him to give up or be killed. But in each case, this rather gormless party boy works with the locals to solve the problem at hand. He demonstrates a number of useful traits for a modern king: taking on powerful corporations for the sake of ordinary people, tactical planning, physical courage, and a willingness not only to sacrifice himself, but to choose wisely among the opportunities to do so. Then he gets given the final task. He’s told to throw himself off of a tower into the courtyard below.

His girlfriend (daughter of one of the junta members, whom he has won over as he’s done the other quests) sends out a message on Facebook: come to the capital, and bring your pillow. All of the people he’s helped in all of his previous quests come, and create a pile of cushions large enough to catch him. He leaps, he lands, he is king.

The common thread between those two children’s movies is the idea that the True Monarch is not just one who does great deeds, nor even one who leads others to do great deeds. The True Monarch inspires people to do great deeds that neither the Monarch nor the people themselves would have dreamed of doing. Monarch as catalyst. It reminds me of the last paragraph of an otherwise hilarious rant about the Elfstedentocht (the Dutch Eleven Cities’ ice-skating race) that I Parheliated last year:

First across the line will be a mysterious giant, a seven-foot tall stranger whose eleven-stamped card identifies him only as a Mr. W.A. van Buren of Wassenaar, and a nation will stand and weep, each and all with the exact exalted grace as did his royal bride those ten long years ago, but this time, the theme to Soldier of Orange will play as a people realizes the true nature of its sudden hero, who will then be crowned king, right then and there on the Bonkevaart all frozen over, on the Twenty-First day of the Second month of the year Two Thousand and Twelve, king glorious King William IV, before the eyes of all of Leeuwarden and all of Freezeland and all of the shining Nation, to be august King of all Dutch, for all Dutch, and all will be well again, all will be well we will not be so angry anymore, and not be so tired, and maybe, just maybe, not so greedy or callous, but noble and caring and quiet and strong, and all will be well, for a thousand triumphant years.

All will be well again, all will be well. We will not be so angry anymore, and not so tired, and maybe, just maybe, not so greedy or callous, but noble and caring and quiet and strong. What is that but the heartfelt cry of longing for the True King, and chance to be the people that he could make us into?

And we Americans aren’t immune from that hunger for someone to make us our best selves either. We just call them Presidents and go through them faster. “Ask not what your country can do for you—ask what you can do for your country.” Yes, you can. Si se puede. Remember the heady days of Obama’s first campaign? That was a real thing: the hunger to have a True President, at least for a while. We hoped he would make us our best selves.

As it happens, two of my three monarchies are in transition at the moment. The monarchy of my residence is easy: Willem-Alexander will be a perfectly adequate king, just as his mother was a perfectly adequate Queen. We’ll sing the Wilhemus and wear orange for his birthday; there may be drinking and flea markets. All will be pretty much OK. May my second-passport monarchy (Windsor) do as well.

But my first monarchy is the one that concerns me right now. The organization is in deep, structural trouble. The holder’s sudden choice to vacate the throne is worrying, and I am torn between curiosity and dread to hear (what we will ever hear of) why he really stepped down. And although I’m sure the Conclave is intending to vote for the Pope who will make us all our best selves, I don’t think they’re the right electorate to identify him. I think they, and the entire hierarchy, have forgotten (or never knew) what it is to be a Catholic in the world. I don’t think they will elect a Pope who will make us our best selves (or them their best selves), and when he does not, I think they will continue to blame everyone but themselves.

I wish it were not so. I’d love a Pope who renewed the church, and turned us from an engine of politics and condemnation to one of love and healing. That’s what I hope for. But I know better than to expect it. Because the True Monarch is a fairy tale, no more real than its cousin-myth of the Philosopher’s Stone. The Conclave will choose someone in scarlet robes who won’t, even if he wants to, be able to turn the rumbling Juggernaut of the hierarchy from its course. In the same way, Willem-Alexander will open hospitals, kiss babies, and change nothing. And Obama will send out more drones.

But the fact that fairy tales don’t come true doesn’t rob them of their value. The problems they describe are real, even if the solutions that follow aren’t. There are no True Monarchs, but the hunger to be our best selves endures. In the end—as in the beginning and the middle—we turn ourselves into those best selves, every day, piece by piece and act by act.

* My favorite task doesn’t really fit the list of classic quests. Stach has to stop four houses of worship that travel endlessly though the streets of Uikumene: a Catholic church, a Protestant church, a synagogue and a mosque. They grind along the roads accompanied by dust and deep rumbling noises, steered by deacons using great wheels behind the pulpits, and worshipers have to run alongside them and hop aboard. It’s wonderful imagery. Stach plots four courses that bring them together in the central square, so that their ceaseless magical momentum holds them in dynamic stasis. He and the mayor use a shared choral performance to coordinate the movements, meaning that the magnificent endeavor is completed to the strains of Ode to Joy. Because, Europe.

In April or May they’re going to lace dead mice with painkillers, attach them to little parachutes, drop them from helicopters and hope that they get snagged in the jungle foliage. Then, if all goes well, the snakes—which, as their name implies, hang out in trees—will eat the mice and die from ingesting the painkillers’ active ingredients.

I think it’s the tiny parachutes that really make this story. I really do.

and pick another result.
Try another search to find what you’re looking for.

Or you can continue to http://www.sfwa.org/2013/02/guest-post-the-importance-of-pie-cooking-the-books-with-james-d-macdonald/ at your own risk. For detailed information about the problems we found, visit Google’s Safe Browsing diagnostic page for this site.

For more information about how to protect yourself from harmful software online, you can visit StopBadware.org.

If you are the owner of this web site, you can request a review of your site using Google’s Webmaster Tools. More information about the review process is available in Google’s Webmaster Help Center.
Advisory provided by Google

Now I am sad, for I was ego-scanning for my Lime Pie recipe over there.

The following content has been identified by the YouTube community as being potentially offensive or inappropriate. Viewer discretion is advised.

Private Snafu was a character in WWII training films. Here is Spies:

Script by Theodor “Dr. Seuss” Geisel, voice characterizations by Mel Blanc, music by Carl Stalling, directed by Chuck Jones, racism, sexism, and xenophobia by American Popular Culture c. 1943.

This is one of the reasons that I find it difficult to believe that the translator/clerk character in Saving Private Ryan didn’t know the term FUBAR. Private Fubar was a character in some of the Private Snafu cartoons, and everyone in the Army would have seen all of them. A lot.

This hasn’t happened since the fifteenth century (and Dante put that guy into the Inferno as “he who made the great refusal” for doing it). [UPDATE/CORRECTION: The fifteenth century was the last time a Pope resigned. Dante’s guy was in the thirteenth century.]

To say this is a surprise is rather an understatement.

Rather than look for nefarious reasons, I think that he got the Word from the Bird: “Popes serve at the pleasure of God Almighty. God is not pleased.”

“Striking me dead wasn’t an option?”

“Yeah, it’s traditional, but We like to shake things up every now and then.”

Or, perhaps, he wants to keep on writing about theology and doesn’t want his personal opinions to be misinterpreted as the Official Catholic Position (no matter how many times he might say, “See that chair? I’m not sitting in it.”) Recall when his last book about Christmas came out and it was all The Pope Doesn’t Believe in Christmas! even though he was mostly saying that traditional Christmas carols are mostly of recent origin.

Well, we’ll see. Looks like Cardinals all over the world are making plane reservations for the first of March.

My beloved younger daughter, while waiting to hear back from grad schools, has been working retail. And recently she won a stuffed dog at work for knowing (during a training session) what a short-change swindle was. So, in hopes that you too will be able to win a stuffed dog, here is the Short Change Con. This one has been going on for a while (here it is in 1906) and there’s no reason to think it’ll stop any time soon.

Way back in The underlying forms of fraud a decade ago, Miss Teresa listed 2. Using high-pressure tactics to confuse or intimidate the victim but commented The list is a work in progress. I’m not altogether sure #2 belongs on it, though I’m not sure why or why not…. Well, it is, and Short Change is a perhaps the purest example of it, purer even than a used-car salesman or PublishAmerica’s versions of High Pressure Confusion Scamming.

You’ll start with a $10 bill, a $5 bill, and 15 $1 bills.
Buy something for under $5.
Pay with a $10 bill.
As your change of up to $5 is being retrieved, ask for another $10 bill for ten $1 bills you’re pulling out of your wallet.
Leave your original $5 change out, but pick up the $10 bill while you hand over only nine $1 bills.
Have them check the count as you go through your wallet, putting away the $10 bill and pulling out more singles.
They will count nine $1 bills, so you add 1 more $1 bill and throw on another five $1 bills and a $5 bill and ask for a $20 bill. Cashiers always like to make smaller change for their drawer.
They put the fifteen $1 bills and one $5 bill away and give you a $20 in return.
You just made $10.

While, in general, reading comments on YouTube videos is a waste of time, in this case the comments are about equal “That was a fake, they were both actors, that’ll never work in the real world” and “OMG that just happened to me today!” In actual fact, this scam is performed successfully somewhere in America once every nine seconds. A scammer can make $40 an hour just by walking up one side of the street and down the other (or from shop to shop in a mall) running this scam; all it has to do is hit once every fifteen minutes. If it doesn’t work, move on to the next place. If someone’s wise to it, what’s there for anyone to prove? You were just confused and made a mistake. Is that a crime now?

It’s a wonderful combination of high pressure and confusion, and no doubt in anyone’s mind that this is a con. A cheat. A swindle. Totally belongs on the list.

Entertaining until you get bitten by one, that is. No one is so street-smart, so cynical, and so canny that the right pitch on the right day by the right person won’t take them. These cons got to be classics by working reliably all day every day. See, for example, this hidden-camera view of the Pigeon Drop being run on a random citizen.

Which brings us around to somewhat similar con, in that the con artist gets change for an overpayment. We’ve mentioned this before: Scams from the Mailbag. There it was the Secret Shopper swindle. You get a spam email offering to make you a Secret Shopper. They’ll send you a check for $3,000. You deposit it in your account, take $200 to make a purchase at a local store (you get to keep what you buy!), get another $100 for your pay, and you send back the change by Western Union to some address. Piece of cake, right? Except two weeks later, when it turns out that the check was forged, you’re on the hook for the entire amount, plus a fee for depositing a bad check. You’ve already sent off $2,700 and change. Which you’ll never see again.

While the short change con relies on people being distracted and trying to be helpful (and cashiers are paid to try to be helpful), the counterfeit check scams rely on people trying to be helpful and honest. (You can, indeed, cheat an honest man.) Here’s the scam in the form of someone who wants to rent a property (or a room, or an apartment) who sends a check for more than the deposit/first month’s rent/whatever and asks the landlord to send back the change.

Which gets us to the current variant. A nice young lady is looking for a job as a babysitter/nanny/whatever, and advertises. In comes a letter, with picture of a cute kid, asking a lot of questions (e.g. “Are you CPR and first aid certified?”). You reply to the letter, having put no small amount of time/effort into answering the questions (thus getting invested in the deal, along with the promised $900/week). Hurrah! You’re hired!

You get a check from some third party, for your first month’s pay, plus a couple of thousand dollars that you weren’t expecting. Now … oh noes! You get a panicky phone call from someone claiming to be the lady who just hired you. She’s in England, having gone there with the Cute Kid to attend her mother’s funeral, and her banker/accountant/lawyer/agent has sent you your pay plus the price of her plane ticket home! She’ll be stranded! Could you be a dear, pop down to the bank, take the overage and wire it to her? Thanks! You’re a peach!

Again, the high pressure.

Then, a week later, the bank tells you that the check didn’t clear, and you’re on the hook for the entire amount, as above.

Today is the one-hundred and fifty-second anniversary of Jeff Davis learning that he was president of the Confederacy.

Jefferson Davis, a former US Senator from Mississippi, was at home trimming his rose bushes when he learned that he’d been selected by the Confederate States of America’s constitutional convention. Up until then the thing he was best known for was designing a hat for the cavalry (the Davis Hat, worn by both sides during the Civil War) while he was Secretary of War.

Jeff hadn’t sought the honor, though he had written to the Governor of Mississippi, “Judge what Mississippi requires of me and place me accordingly.” My guess is that he was hoping to be appointed a general in the Mississippi militia. Davis’s wife, Varina, said later, “Reading that telegram he looked so grieved that I feared some evil had befallen our family. After a few minutes he told me like a man might speak of a sentence of death.”

He was an odd choice for Confederate president given that he had spent most of his Senatorial career arguing against secession. He was, however, a plantation owner and slave holder, which made him a logical choice.

Davis himself had no confidence in his ability to carry out the duties of the office. And he saw clearly the difficulties that lay ahead. “Upon my weary heart was showered smiles, plaudits, and flowers, but beyond them I saw troubles innumerable. We are without machinery, without means, and threatened by powerful opposition but I do not despond and will not shrink from the task before me.”

He was right about being without machinery and means: What kind of a country starts a war when it doesn’t own a single cannon factory? His wisest move might have been to make his first act in office to sue for peace while begging for readmission to the Union.

Some years ago I recall (but cannot now find on the Google-indexed web), a cereal company had a US Presidents word-search puzzle printed on the back of the box. And, seemingly by chance, the name “Davis” appeared in the puzzle (though not on the official list of answers). While looking for documentation on that event I did discover that you can get a picture jigsaw puzzle of Jeff Davis dancing on an American flag.

While Davis was charged with treason he was never tried. He was stripped of US citizenship and ability to run for public office, though it was eventually returned to him by congress in 1978. A pity he didn’t run in ‘80; he was a Democrat and might have beaten Reagan.

It is not true that Jeff attempted to avoid capture by Union troops by dressing in women’s clothing. He was wearing Varina’s shawl because it was cold.

My personal connection: My co-author, Doyle, is related (on the Taylor side of the family) to Jeff Davis’s first wife, Sarah.

We’ve talked about various heat-and-cold injuries to the body: Cold Blows the Wind Today and Heat Stress. Now it’s time to talk about something a bit more acute and a bit less systematic: Traumatic burns.

Now it’s time to get into the guts (so to speak) of Burns. Burns are some of the most frightening injuries. They are some of the most painful injuries. And, they can be life-threatening.

Sorry, folks, no pictures. Y’all can find ‘em on your own.

While burn injuries are classified as trauma, they have some significant differences from most other kinds of trauma. Normally, after (say) blunt trauma (e.g. falling off a roof) the body responds by constricting blood vessels, increasing heart rate, forming clots, shifting fluid to the area to allow white cells to access the injury, and similar good stuff. By contrast, with a major burn, the body’s defense mechanisms paradoxically cause it to shut down, go into shock, and die. Vasoconstriction and clotting can increase the size and severity of the burn while so much fluid may shift that it will throw the body into hypovolemic shock. Treatment of burns, prehospital, focuses on stopping or reversing those processes.

First: Stay safe. You can’t help a patient if you become a patient yourself. Downed power lines stay dangerous until someone wearing a white hard hat says they’re safe.

Second: Stop the burning process. If someone is on fire, put them out.

While the flames (and the thermal burns they produce) are the dramatic part of fire, the most dangerous part of a fire is the smoke. A very small amount of smoke inhalation can be fatal. Smoke, in addition to the particulates, can carry carbon monoxide, hydrogen cyanide, sulfur dioxide, and other chemical goodies. Usually, unless you’re looking at a steam burn, you won’t see a lot of actual thermal injury inside the lungs. Dry air doesn’t carry a lot of heat. But those particulates and gasses can produce chemical burns to the lungs even if they aren’t directly poisonous, producing chemical pneumonia and … this is bad.

The amount of smoke inhaled is the number one predictor of mortality in burn injuries, way ahead of the age of the patient or the surface area of the burn. Continue to be suspicious with someone who has escaped from a fire. Sometimes the symptoms of smoke inhalation don’t appear for hours or days.

The importance of smoke became obvious after the Cocoanut Grove Fire in Boston in 1942. Seemingly uninjured people who had escaped the fire and come to the hospitals looking for friends were falling down and dying in the waiting rooms. The presence of plastics was what had changed: Some of plastics’ byproducts of combustion are purely nasty.

While burns are not just injuries of the skin, that’s where we’re going to start as we look at this kind of injury. Often the first signs of burn injury appear on the skin.

Your typical adult has somewhere around 1.5 to 2 square meters of skin, divided into two layers: The epidermis on top, and the dermis below that. Below the dermis come the subcutaneous layers. The skin of males is typically thicker than the skin of females. The skins of children (<5) and elderly (>65) are typically thinner than adults. The skin is the largest organ in the body. It has three primary functions: Infection control, heat regulation, and water control. Burn injuries compromise all three of these functions.

Sometimes you hear burns classified as superficial, partial thickness, and full thickness. The “thickness” referred to is the thickness of the skin. I’m going to use another system of nomenclature: First degree, second degree, third degree, and fourth degree.

Your body contains an awful lot of protein. Proteins are complex molecules that easily denature with heat. When the body is burned, the central, most highly damaged, part of the burn is called the zone of coagulation. Which is exactly what it sounds like: The tissues have been hard boiled. The proteins have coagulated. The cells there are dead; they will not regenerate. Another cheerful name for this zone is the “zone of necrosis.”

The area surrounding the zone of coagulation is the zone of stasis. The cells there aren’t dead, but they are injured. Blood isn’t flowing to them; nutrients aren’t getting to them; oxygen isn’t getting to them. Without oxygen and nutrients those cells will die, and the zone of necrosis will expand.

Around the zone of stasis is the zone of hyperemia. Cells in this area are damaged, but not too badly, and are getting increased blood flow; the increased blood flow is part of the body’s normal reaction to any injury. The blood vessels get “leaky” to allow fluid to enter the intercellular space (between the cells) which allows white blood cells to access all parts of the injury. This causes swelling (edema) as the area puffs up with water.

It’s deucedly difficult to tell how deep a burn is immediately after the injury using a Mark One Eyeball. A burn that appears superficial may actually be deep, and that fact may not be apparent for up to 48 hours after the injury (when the top layers of the skin slough off). That being said, let’s talk about burn depths.

First degree burns. These only involved the epidermis (from epi - above; dermis - skin). These are the ones that are also called “superficial.” The epidermis varies in thickness from 1/20 of a millimeter on the eyelids to 1 millimeter on the soles of the feet. The signs are redness, the symptoms are pain. Usually they heal by themselves within a week without scarring. Large area superficial burns risk dehydration and the pain may be intense. The classic first degree burn is sunburn. Drink a lot of water and avoid re-injuring the area before it’s healed.

Second degree burns. These are also called “partial thickness burns” because they go part-way through the dermis. The most obvious feature of second degree burns are surface blisters or bare patches with a wet, glistening appearance. Exactly how severe a second degree burn is depends on how deep it is and how it’s cared for. A comparatively shallow second degree burn, with circulation rapidly returned to the zone of stasis, can heal on its own with normal wound care in two to three weeks. A deeper second degree burn, or where the zone of stasis is allowed to progress to necrosis, may require surgical treatment. An improperly treated second degree burn can convert into a third degree burn. Which you’re looking at is hard to determine on-scene. Second degree burns are also quite painful. Even air moving across the skin may be unbearable. (This is because the epidermis may be gone so that the nerve endings are directly exposed to the environment.)

Third degree burns. Sometimes called “full thickness” burns. They go all the way through the dermis. These burns generally have a thick, dry, leathery, white appearance (regardless of the race or skin color of the patient). The skin may appear charred. Blood vessels may be obviously congealed. These burns require surgical care and rehabilitation in specialty centers.

While third degree burns are classically painless (since the nerves are completely destroyed), they are generally surrounded by areas of second and first degree burns which are exquisitely painful.

Fourth degree burns are those that penetrate the skin entirely, with damage to the underlying fat, muscle, bone, or organs.

Let’s talk about blisters for a minute. They occur when the epidermis separates from the dermis and the space beneath the epidermis fills with fluid leaking from the damaged tissues below. This fluid contains proteins; it therefore continues to draw water into itself by osmotic pressure. Thus, blisters tend to grow, putting pressure on the wound beneath and increasing pain. Blisters do not actually act as a barrier to infection since they are not normal skin. But the need to drain and debride them is handled in a burn center, not in the field. If/when a blister opens, topical antiseptics are used to help prevent infection. Secondary infections after burns can be life-threatening.

Burns produce a massive fluid shift inside the body, from the blood vessels to the intracelluar space. Even more fluid is lost through evaporation. This produces hypovolemic shock. The treatment for this is massive amounts of intravenous fluid; according to the Parkland Formula (named after the hospital where it was devised), that’s 4mL of normal saline IV per kilogram of body weight per percent of surface area burned, with half of it delivered in the first eight hours after the time of injury and the rest over the next sixteen hours.

Please note that while massive fluid shifts are taking place, they take place over a period of hours. If the patient is showing signs of shock immediately or over a period of minutes, there’s more going on than just the burns: Look for broken bones, lacerations, and other trauma. Someone who fell down stairs or jumped out a second-floor window trying to escape a fire has those injuries too and you’ll have to deal with them; they may kill the patient before the burn has a chance to do it. Burns are dramatic and grotesque injuries. Don’t let them distract you from noticing that the patient is also having a heart attack, diabetic emergency, stroke, or other medical problem.

So what do we do, in the field, for burns?

First, as mentioned, stop the burning process. This does not mean “cool the burn.” The best way to stop the burning process is by flooding the area with large amounts of tepid water. Applying cold water or ice is contraindicated because that has the effect of making the blood vessels in the area constrict. Constricted blood vessels stop blood flow. But we’re trying to get blood to flow to the zone of stasis. Cold water or ice can convert the zone of stasis to the zone of necrosis and turn a shallow second degree burn into a deep second degree burn, or a second degree burn into a third degree burn. Yes, ice will numb the pain. But you’d be far better off using an oral painkiller for that, or just telling the patient to hang in there and gut it out.

In the course of stopping the burning process remove all jewelery and clothing from the patient. Those items retain heat, or trap chemicals, or constrict the body when the obligate edema occurs. All bad things.

Protect the area with dry, sterile (if you have ‘em) non-adherent (if you have ‘em) dressings. Wrap the patient in a clean dry sheet. You want to limit airflow over the wound. If you have a burned hand, put dressings between the fingers. Don’t put on creams or lotions — they may retain heat, or they may make it difficult for the nice folks at the burn center to assess the injury, and may make it impossible for them to use certain treatments (e.g. tissue-engineered products). (And it’s going to hurt like a dog when they scrape the goo off, too.)

As in any injury, maintain the patient’s airway, breathing, and circulation. While you’re stripping off all his/her clothing, pay attention to other injuries that may be revealed. One thing that you can do: Check every pulse point that you know. Take your Sharpie Pen and mark the ones that have pulses. Later on, swelling may make those pulses vanish, but the nice doctors will thank you for finding them.

Burn patients are unable to maintain their own body temperature. The skin controls temperature; they’ve lost their skin. After you’ve wrapped them in that clean, dry sheet, wrap them in a couple of blankets. Get them somewhere warm. Turn up the heat. If you aren’t uncomfortable it isn’t warm enough.

Now some special kinds of burns:

1) Electrical burns. Typically the injury appears less severe than it really is, since the only obvious surface burns are at the points of contact, but the damage is done internally as the electricity goes from the source to ground. Along with the destruction of tissue in general there’s a special (and this is in common with crush injuries); when muscle is injured it releases potassium, with can cause fatal heart arrhythmias, and it releases myoglobin, which causes kidney damage. Fractures due to muscle contraction are also a real possibility. In an electrical burn assume that the patient’s back or neck is broken.

2) Circumferential burns. That is, they go all the way around either a limb or the chest. On a limb, a circumferential burn can act like a tourniquet and stop blood flow to the outer portions of the limb, resulting in tissue death. Around the chest, a circumferential burn can make it difficult or impossible for the patient to expand the chest and breathe. This is bad.

3) Smoke inhalation. I’ve mentioned this twice already, but it really is that important. Burns to the face or mouth, or a patient who’s spitting up black sooty phlegm, should make you think of smoke inhalation. But just because you don’t see those signs doesn’t mean the patient didn’t get a lethal lungful. Any time you have combustion you have carbon monoxide. Symptoms include nausea, vomiting, lightheadedness, and vague flu-like symptoms. Or, unconsciousness and death. The primary treatment is to get the patient away from the source of carbon monoxide. The half-life of carbon monoxide in the body when breathing normal air is 250 minutes. When breathing 100% oxygen, the half-life of carbon monoxide is forty to sixty minutes. So, oxygen if you have it. Cyanide — the treatment for cyanide is rapid transport to an emergency room that has the antidote available. Particulates: The treatment is even more IV fluid, because the surface area of the burn is lots bigger than it looks. Sulfur dioxide, ammonia, hydrogen chloride — all present in smoke — can create damage in the lungs that doesn’t become apparent for days after the exposure. The amount, the duration of the exposure… don’t assume you’re out of the woods just because the patient seems to be fine the next day. Anyone who’s been in or near a fire needs to be observed for a considerable time.

4) Chemical burns. Treat them like thermal burns, using large amounts of tepid water to stop the burning process. By “large” I do not mean “a liter or two” or even “a gallon or two.” I mean throw-them-in-the-shower or turn-a-garden-hose-on-them for twenty minutes. (Don’t attempt to neutralize acids or bases; the chemical reaction between the two may create heat, producing further injury, and anything strong enough to neutralize a strong acid or base is itself hazardous.) Remember, the water that you’re using to flush the injury is itself contaminated and may be hazardous to you. Be careful. Protect yourself first.

When you’re calling the hospital to tell them that you have a burn patient, the two things they want to know are a) the patient’s weight, and b) the percent of the body surface area that’s burned. One way of estimating body area is the Rule of Nines. (Another way is by estimating how many times the patient’s palm would cover the burn; the palm of the hand is about 1% of the patient’s skin surface.)

Bottom line: All burns are serious, regardless of their size. There is no such thing as a “minor” burn. Unlike other forms of trauma the body has few-to-no natural defense mechanisms. The defense mechanisms that it does have tend to worsen the injury. On the plus side, burns are seldom rapidly fatal. You have time to get the patient to a burn center.

The leading cause of death in burn patients is smoke inhalation. Even in the absence of surface burns any patient with smoke inhalation should be taken to the hospital, and may well be transported to a specialty burn center after evaluation.

A patient with burns means that the situation is dangerous. Be careful. Do not become a victim yourself.

I want to highlight and poke at something that Jacque said in the last DF thread:

…having spent one’s formative years surviving and protecting that embryo—and one finally Gets Out, and all of a sudden it’s “Now what?” Surviving is a fundamentally different skill-set from Thriving.

This community talks a lot about how the expectations that the children of dysfunctional families have turn out to be wrong in the outside world. Something goes wrong and there is not inevitably an immediate explosion of fury and blame. Arguments are often a tool for resolving differences, not deepening them. Instead of defensiveness and denial, wrongdoing is usually followed by apologies and restitution. Relationships generally run on joy and generosity rather than fear and obligation. Coming from a dysfunctional background, it must be like walking into a mirror universe.

(The above paragraph has been updated in bold with Lee @4’s suggestions. Thanks to her and Pvt_Prvt @2 for highlighting my over-generalizations, and I apologize to anyone whom they hurt or made feel uncomfortable.)

It’s inevitable that the skillsets of people who grew up amidst dysfunction will be similarly out of synch. The transition from the old to the new is only partly geography; the real challenge is moving out of the habits and reflexes that made it possible to survive an abusive situation. We often talk about this transformation in the negative: not doing this destructive thing, not listening to that tape. And all of that is hugely important.

But if thriving is a different thing than surviving, how does a survivor start? How does someone build a new, functional self on a shaky foundation? What are the tools, tricks and habits to acquire to not just exist in this new world, but blossom in it?

And can a person still in the old situation lay the foundations for those skills, tuck them away like linens in a hope chest for a better future?

This is part of the sequence of Dysfunctional Families discussions. We have a few special rules, specific to the needs and nature of the conversations we have here.

If you want to participate but don’t want your posts linked to your contributions to the rest of Making Light, feel free to choose a pseudonym. But please keep it consistent within these threads, because people do care. You can create a separate (view all by) history for your pseudonym by changing your email address. And if you blow it and cross identities, give me a shout and I’ll come along and tidy it up.

On a related note, please respect the people’s choice to use a pseudonym, unless they make it clear that they are willing to let the identities bleed over in people’s minds.

If you’re not from a dysfunctional background, be aware that your realities and base expectations are not the default in this conversation. In particular, please don’t do the “they’re the only family you have” thing. Black is white, up is down, and your addressee’s mother may very well be their nemesis.

Be even more careful, charitable, and gentle than you would elsewhere on Making Light. Try to avoid “hlepiness” (those comments which look helpful, but really aren’t). Apologize readily and sincerely if you tread on toes, even unintentionally. This kind of conversation only works because people have their defenses down.

Never underestimate the value of a good witness. If you want to be supportive but don’t have anything specific to say, people do value knowing that they are heard.

Previous posts (note that comments are closed on them to keep the conversation in one place):

Looks like the New England states, New York City, Long Island, and places south and west of there will get kinda clobbered this weekend. As in, starting Friday night. Up to two feet of snow; blizzard conditions, coastal flooding. We’re doing the storm-from-the-south meets storm-from-the-northwest thing again.

So, in preparation, here’s a list of Making Light posts that dealt with some of the issues we’re going to be seeing:

This storm looks like it’ll be backed by hurricane-force winds, so all the posts about hurricane preparedness stand: Hurricane Lantern.

During a snow event, a major killer is carbon monoxide. Snow blocks vents. Snow makes us keep the windows shut tight. And, when the power fails, sometimes snow makes us do silly things involving open flames or charcoal indoors. Check your carbon monoxide detector and recall that anything that has a flame is producing CO: Stop, Drop, and Roll.

So, stay safe, everyone. Don’t travel if you don’t have to. And remember: Weather disasters mean it’s time to make French Toast! (NOTE: While stocking up on bread, milk, and eggs, don’t forget the butter, bacon, and syrup. What kind of savages are you, anyway?)

Via James Nicoll, I read that MCA Hogarth, an author and artist whose work I was not previously familiar with — still aren’t, really, since it’s five in the ay-em right now and I just want to write this up quick and get to bed — seems to do a lot of self-publishing, and recently discovered that one of her books, Spots the Space Marine has been blocked from sale on Amazon, after a claim of trademark infringement from Games Workshop.

Since 1987, GW has published a series of games (and ancillary merchandise) get in their “Warhammer 40,000” setting, full of spike-covered pseudo-elves and pseudo-orcs amd chainswords and the like, all set in space (instead of on a planet like their original Warhammer setting). GW has apparently decided that, since they’ve got space marines in their setting, they own the very concept of space marines.

Hogarth has talked to several lawyers, and they’re all willing to take the case, but not pro bono. The legal costs “start at $2000 and climb into the five-figure realm”, which is more than she stands to make off the book if she does get to sell it. I figure Hogarth might be able to use some added attention.

We still use a number of my husband’s fast/cheap/good recipes, if you’re interested. Examples: Ethiopian Lentil Bowl, which basically involves equal parts red lentils and garlic, plus some canned tomatoes and lemon juice. Or what we call “Hyrulean Beans” (he was playing a lot of Legend of Zelda when he invented this one) which is stewed refried beans, tomatoes, and fried onions with a few common herbs/spices, with frozen corn thrown in toward the end. In both cases, serve with rice for a complete protein, and in both cases they make LOADS and freeze well.

If you want detailed recipes for these or others, perhaps one of the mods could put us in touch?

Well, to start: My beloved bride (and long-time co-author), Debra Doyle, hath (like Geoffrey Chaucer) a blog, in which she from time to time puts recipes. Since what we eat here is, pretty much all of it, fast, easy, cheap, and good, herewith is a sample, to start the pot heating (as it were):

The looming deadline looms ever nearer, and tonight’s dinner is therefore dazzling in its simplicity: Crockpot Kielbasa and Cabbage.

For which you need only a crockpot, a head of cabbage, and about one pound of kielbasa. You cut up the cabbage into small enough pieces that it’ll fit into your crockpot, you cut up the kielbasa into half-rounds, and you slow-cook them together on low until dinnertime. Some people put caraway seeds into the pot with the cabbage, but we’ve got at least one anti-caraway person in this household, so I don’t.